Individual provider Active NPI

Joseph Jannuzzi, DPT, SCS

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1053756882
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2294 S Riva Ridge Ave
Boise, ID 83709-2507
Phone
(208) 949-0568
NPI assigned
May 7, 2013
Last updated
Jul 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Sports Physical Therapist 2251S0007X PT-3152 ID
Orthopedic Physical Therapist 2251X0800X PT-3152 ID

Addresses

Primary practice location

2294 S Riva Ridge Ave
Boise, ID 83709-2507

Mailing address

2294 S Riva Ridge Ave
Boise, ID 83709-2507
Phone (208) 949-0568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909003427 ID Practitioner - Physical Therapist in Private Practice 3779989140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Mountain Physical Therapy PLLCGroup PAC ID 0345213278, 3 clinicians

Practice addresses (Care Compare)

1441 Pkwy Dr
Suite 1
Blackfoot, ID 83221-1667
Phone (208) 785-3446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-3152IDMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Physical Therapy PLLC Physical Therapist CurrentSince Sep 2, 2025 Accepting new patients

Locations

1441 Parkway Dr
Blackfoot, ID 83221
Phone (208) 785-2600

1441 Parkway Dr
Ste 1
Blackfoot, ID 83221
Phone (208) 785-3446

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1053756882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2294 S RIVA RIDGE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092507",
            "telephone_number": "208-949-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2294 S RIVA RIDGE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092507",
            "telephone_number": "208-949-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNUZZI",
        "first_name": "JOSEPH",
        "credential": "DPT, SCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "ID",
            "license": "PT-3152",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ID",
            "license": "PT-3152",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.